CPAP Therapy Reduces Depression in Sleep Apnea

the Psychiatry Advisor take:

Research shows that depression is extremely common in patients with obstructive sleep apnea, and that their depressive symptoms improve greatly when they undergo continuous positive airway pressure (CPAP) therapy.

The study, published in the Journal of Clinical Sleep Medicine, evaluated 426 patients (243 males and 183 females) for suspected sleep apnea. Participants had a mean age of 52 years. They were evaluated for depressive symptoms using the Patient Health Questionnaire (PHQ-9), and the presence of sleep apnea was determined using overnight, in-lab polysomnography. Of the 293 patients diagnosed with sleep apnea, 228 received CPAP therapy for an average of 5 hours or longer per night for three months.

At the beginning of the study, nearly 73% (213 of 293) of the patients with sleep apnea had clinically significant depressive symptoms that increased with sleep apnea severity. However, after undergoing CPAP therapy for 3 months, only 4% (9 of 228) of the sleep apnea patients still had remaining depressive symptoms. Of the 41 patients who reported feelings of self-harm or that they would be “better dead” at the beginning of the study, none reported persisting suicidal thoughts at the three-month follow-up.

“Effective treatment of obstructive sleep apnea resulted in substantial improvement in depressive symptoms, including suicidal ideation,” said senior author David R. Hillman, MD, clinical professor at the University of Western Australia and sleep physician at Sir Charles Gairdner Hospital in Perth. “The findings highlight the potential for sleep apnea, a notoriously underdiagnosed condition, to be misdiagnosed as depression.”